Alteration of the Respiratory Microbiome in Hospitalized Patients with Asthma–COPD Overlap during and after an Exacerbation

Abstract

The immediate aim of this study was to comparatively examine the bacterial respiratory microbiome of patients in a stable state and during an exacerbation of asthma–COPD (chronic obstructive pulmonary disease) overlap (ACO). This prospective observational study took place in Jordan between 1 September 2021 and 30 April 2022. Sputum samples from patients with recognized ACO were acquired within 48 h of the exacerbation onset and again at 3 weeks following the exacerbation. The next-generation sequencing Illumina MiSeq was employed and uncovered significantly high bacterial diversity in the sputa. The results showed a significant decrease in the taxonomic richness in the sputum samples collected during the exacerbation episodes compared with those collected from patients in a stable state (p = 0.008), with an increase in the taxonomic evenness (p < 0.005). This change in the composition of the airway bacterial community suggests that the replacement of a significant portion of the airway microbiome with certain microorganisms may play a role in the decrease in microbial diversity observed during an ACO exacerbation. Greater knowledge of this link could allow for a more focused administration of antibiotics, especially during exacerbations, improving clinical efficacy and patient outcomes.

Asthma-COPD Overlap in Clinical Practice (ACO_CP 2023): Toward Precision Medicine

“…Moreover, high-throughput Illumina MiSeq, used in this recent work [34], revealed a large amount of bacterial variety in sputum. Similar to earlier COPD investigations utilizing culture techniques, this study found substantial abundances of the bacterial aerobic genera Streptococcus, Haemophilus, Pseudomonas, and Moraxella [35,36].…”

“…In this study, the lower airways of clinically stable ACO patients were found to have bacterial colonization, which makes it challenging to establish the role of bacteria in exacerbation. The examination also revealed significant differences between the study groups [34].…”

“…In 2023, we published the first investigation in the literature which characterized ACO patients' bacterial respiratory microbiome in both stable and exacerbation states [34]. The study utilized Next Generation Sequencing (NGS) to reveal the composition of the pulmonary microbiome and detect bacteria that may have been missed by traditional antimicrobial therapy due to cultural challenges.…”

“…In the exacerbation condition, the taxonomic richness of bacteria decreased, and the evenness of microbiota increased compared to stable states in ACO patients. This shift in the airway bacterial population suggests that significant pathogens may replace most of the airway microbiome during an exacerbation, decreasing microbial richness [34]. The Prevotella genus was found to be substantially more abundant in exacerbation samples than in stable samples, suggesting that some species of Prevotella may contribute to ACO pathogenicity [34].…”

2020–2021 rhinovirus genetic diversity in Saint Petersburg

“…Известно, что распространение нового коронавируса SARS-CoV-2 сопровождалось существенным ограничением циркуляции целого ряда возбудителей сезонных респираторных инфекций, за исключением риновирусов и респираторно-синцитиального вируса [5]. Согласно полученным нами данным, в этот период самыми распространенными оказались риновирусы вида A, что соотносится с другими исследованиями [2,21,40]. Также нами установлены возрастные и клинические различия в зависимости от вида риновирусов.…”